AR Specialist FT

Gibson-Area-Hospital-; Gibson City (IL); On-site; USD 42,000 - 64,000; Full time

Job summary

Gibson Area Hospital & Health Services is seeking a CBO Representative to manage accurate and timely billing and follow-up for all claims, ensuring prompt payments from payers. You will coordinate with multiple departments to resolve billing issues and improve cash flow.

The role involves daily reporting, payer communications, and handling inquiries from patients and insurers, with a focus on compliant, efficient processes in a hospital setting.

Qualifications

• Experience with billing forms for different insurers.
• Knowledge of medical terminology and payer rules.
• Analytical skills to review claims for errors.
• Strong communication with patients and payers.
• Familiar with ethical compliance in charging and billing.
• AAHAM CRCS certification preferred.

Responsibilities

• Run required daily reports for billing follow-up on patient accounts across Medicare, Medicaid, Blue Cross, Commercial and third parties.
• Make outgoing calls and answer inquiries from patients, insurers and other parties regarding claims status.
• Ensure timely follow-up with payers per established policies and procedures.
• Review patient account information from admissions and outpatient registration.
• Provide clear responses to billing questions from customers.
• Process EOBs and correspondence within 2 business days.
• Re-bill and reprocess denials and rejections, exploring all avenues to resolve issues.

Skills

Billing knowledge

Analytical skills

Medical terminology

Communication

Compliance

Education

AAHAM CRCS certification preferred

Tools

Billing software

Job description

HOURS & SHIFT REQUIREMENTS: Regular full time. 40 hours weekly. Monday thru Friday 8:00am - 4:30pm.GENERAL SUMMARYThe CBO Representative is responsible for accurate and timely billing and follow-up of all claims to ensure prompt payment from all payers. This would include all communication and research regarding patient accounts with all departments involved.GIBSON AREA HOSPITAL & HEALTH SERVICES MISSION STATEMENTTo provide personalized, professional healthcare services to the residents of the Communities we serve.PRINCIPLE DUTIES AND RESPONSIBILITIES1. Run required daily reports for preparation of billing follow-up of patient accounts with all Medicare, Medicaid, Blue Cross, Commercial and all third parties.2. Make Outgoing & Receive incoming calls and answer inquiries from patients, insurance companies and all other parties regarding the status and billing questions concerning claims.3. Ensures appropriate, accurate/timely follow-up to all insurance companies based on established policies and procedures.4. Review patient account information received from admissions and out patient registration. Identify any missing information and determine what avenue to take to insure timely follow-up.5. Adequately responds to billing questions and provide clarification to customers.6. Develops and maintains appropriate communication with insurance payers, outside agencies and internal departments.7. Appropriately refers all non-routine issues to management for clarification.8. Accountable for updating and preparing correspondence to customers and insurance payers as necessary.9. Effectively communicate to customers needs with the appropriate level of urgency.10. Process and scan all EOB’s/Correspondence received within 2 business days.11. Re-bill and reprocess all Denials and Rejections ensuring all avenues are explored to resolve and issues with Insurance Payers.12. Take incoming calls from patients regarding their insurance and billing.13. Process all walk-ins14. Resolution of Credit Balance reports Monthly.15. Ability to work with fellow staff in a professional, courteous and respectful manner at all times.16. All other duties assigned by Director of PFS or Executive Director of Revenue Cycle.17. Work the denial program daily.PHYSICAL REQUIREMENTS1. Work requires knowledge of PC’s keyboard, calculations, copy machine, printers and other office equipment.2. Light level of physical effort required for a variety of physical activities to include lifting, standing and sitting at a workstation for up to four hours at a time.Physical strength to perform the following lifting tasks:• Floor to waist - 10 pounds• Waist to shoulder - 10 pounds• Shoulder to overhead - 10 pounds• Carry 10 pounds for 15 feet3. Work requires visual acuity necessary to observe and obtain information and use documentation.4. Auditory acuity to hear others for purposed of fluent communication.REPORTING RELATIONSHIPReports to the Director of Patient Financial Services.EDUCATION, KNOWLEDGE AND ABILITIES REQUIRED:1. General knowledge of mathematics and accounting principles.2. Previous experience with billing forms required for different insurance plans.3. Knowledge of Medical Terminology.4. Familiar with the Legal and Ethical Compliance in charging and billing.5. Previous experience in the policy and procedures of billing.6. Requires analytical skills to evaluate claims for errors in billing and payment from payers.7. Knowledge of patient’s rights.8. Good communication skills to assist patients with billing questions and concerns.9. AAHAM CRCS certification preferred.INFECTION EXPOSURE RISK LEVELCategory 3 - No Risk - Your job does not involve exposure to blood, body fluids or tissue. You do not perform or help in emergency medical care or first aid as part of your job.WORKING CONDITIONS1. Works in an office where there are relatively few discomforts due to dust or dirt. There is some exposure to print noises.2. Will work in an office with co-workers where traffic may be constant, subjecting your work to interruptions, which can produce stress and fatigue.